CHAPTER

10.

D ENTAL CARIES, D IAGNOSIS, T REATMENT P LANNING AND P REVENTION

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Salivary Viscosity Test The viscosity of saliva is determined by comparing it with that of water. Special Ostwald pipette with a caliberated bore is used. First 5 ml of water is introduced in to the pipette and allowed to flow by gravity from an upper mark on the pippette past a lower mark. The time in seconds needed to pass these The procedure is then repeated with 5 ml of saliva specimen .The relative viscosity is calculated by the following formula. Time required for the saliva Relative viscosity= - . - -- - . - - - - - -Time required for the water The relative viscosity should be about 1.3. Greater the relative viscosity, higher the caries incidence.
DENTAL CARIES VACCINE

With the never ending research on dental caries and the zeal to find newer methods of caries control and prevention, there has been a renewed interest in developing an anticaries vaccine. Dental caries is a disease process initiated by the bacteria like Streptococcus mutans on the surface of tooth structures, without a direct exposure of the organisms to the immune system of the body.The result is that, the body is unable to produce antibodies against these caries producing organisms. A vaccine which can stimulate production of antibodies against these organisms and which can find its way in to the saliva through IgA can theoretically then prevent colonization and adherence of these bacteria on to the tooth surface. Since enhanced colonization of teeth by S.mutans involves glucons from dietary sucrose, inhibition by antibodies of the enzyme involved in glucon synthesis could prevent S. mutans induced caries, Indeed, the S. mutans dextransucrase is the primary candidate for use as an antigen in the vaccine. . In animal experiments antibodies directed against S.mutans reduce S.mutans count, have been tried. Another facet of caries immunization involves the passive direct transfer of antibodies in to the mouth through milk of immunized animals as caries affects children at a time when they consume plenty of milk. In one approach, harmless strains of bacteria which have been genetically transformed have been introduced orally into experimental animals as oral vaccine and a partial success has been achieved in eliciting antibody a partial success has been achieved in eliciting antibody response and a reduction in caries incidence in these animals. Other studies have shown that packing the antigen in fatty globules enhances secretory antibody response even to poor antigens. Applying antigen fragments, or monoclonal antibodies to the gingiva has shown considerable reduction in oral colonization. Immunization studies offer much promise, but still are their infancy stage, and have been only in animal studies. Immunization of humans is unlikely in the immediate future. If it can be achieved, it will be the greatest break through in caries prevention 2 parts is recorded.
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